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Bacterial vaginosis is the most common vaginal infection among women [1] but most women know BV because of the fishy vaginal odor it causes [2]. Every year, 10 to 35 percent of all women will have BV, including pregnant women, and 10 to 15 percent of these women will have a preterm birth [3]. The infection can be due to smoking, having frequent sex, having sex with women, receiving oral sex, an increase in male partners and an increase in partners in general [3].

However, bacterial vaginosis is not a sexually transmitted infection. The infection is caused by insufficient lactic acid that contributes to bacteria overgrowth and vaginal inflammation [3] – lactic acid stored in fermented foods or our gut. Without enough lactic acid, there is a preterm birth risk.

When women consume fermented foods, like miso, yogurt, or fermented soybeans, they consume the lactic acid needed to prevent bacterial vaginosis and premature rupture of membranes that induce birth [4]. The lactic acid formed during the fermenting of food produces beneficial lactobacilli for the gut, and these lactobacilli prevent bacteria overgrowth and vaginal inflammation. Without bacteria overgrowth and vaginal inflammation, the bacterial vaginosis and preterm birth risks lower. Among women with BV, there are diets high in fat, sugar, and processed foods, inducing a greater risk of preterm birth [5, 6].

To reduce the risk of chronic BV and BV-related preterm births, fermented foods are important, but so is folate, vitamin A, and calcium [6]. No man or woman can survive on kimchi alone. Eating an abundance of vegetables, fruits, gluten-free and unprocessed grains, healthy fats and lean protein lowers the risk of preterm birth and small-for-gestational-age infants [5]. A diet that incorporates healthy fats, protein, produce, and fiber benefits the vagina by reducing the risk of vaginal odors for all women and preterm births for pregnant women.

Fats like baked goods sold on market shelves, margarine, and fried foods aren’t the fats we need to consume. Processed fats are not healthy fats. According to The Nutrition Source at Harvard T.H, Chan School of Public Health, healthy fats come from sunflower, corn, soybean, flaxseed, olive, peanut, and canola oils; avocados; nuts; seeds; and fish. The Omega 3,6,9 fatty acids we receive from these nuts, seeds, and oils help the reproductive tract fight infections and help our bodies support a pregnancy to term. Although they can be enjoyed on their own, the oils can also be used to prepare additional nutrients.

In spite of my lack of interest in eating liver with my grandmother my entire life, a mere three ounces of beef liver is over 50 percent of the daily recommended value of folate, according to National Institutes of Health Office of Dietary Supplements. But if your love for food is not animal-based, ½ cup of spinach three times a day provides our bodies with all the folate and Vitamin A we need every day. If you opt for the beef liver instead, the serving also has 731 percent of the recommended amount of Vitamin A, but the best plant-based option for Vitamin A is a single sweet potato, which delivers more than 100% of the recommended daily value of Vitamin A. While food folates contain folic acid, Vitamin A supports healthy functioning of reproductive organs. Calcium, on the other hand, is much harder to supply, but 30 percent can be found in most yogurts, both dairy and plant-based and fortified orange juices. As a lover of coconut milk and milk that’s coconut-only, I would have loved to know my calcium could come from juice. Calcium ensure reproductive tissues remain healthy.

For the 42 percent [7] of women who are not cured of BV within a year a of receiving treatment, diet is rarely discussed by clinicians. But, there is an evidence-base which supports the use of healthy eating to prevent BV and BV-related miscarriages. Among the many causes of preterm births, BV is rarely, if ever, discussed. Yet this article serves as a guide for women who have been silently struggling with bacterial vaginosis and miscarriages. All women benefit from diets that prevent preterm births before and during pregnancy.


References

1.​ Bradshaw, C.S. and R.M. Brotman, Making inroads into improving treatment of bacterial vaginosis – striving for long-term cure. BMC Infectious Diseases, 2015. 15(292): p. (29 July 2015).

2.​ Bilardi, J.E., et al., The burden of bacterial vaginosis: women’s experience of the physical, emotional, sexual and social impact of living with recurrent bacterial vaginosis. PloS one, 2013. 8(9): p. e74378-e74378.

3. Manns-James, L., Bacterial Vaginosis and Preterm Birth. Journal of Midwifery & Women’s Health, 2011. 56(6): p. 575-583.

4.​ Ito, M., et al., Fermented foods and preterm birth risk from a prospective large cohort study: the Japan Environment and Children’s study. Environmental health and preventive medicine, 2019. 24(1): p. 25-25.

5.​ Chia, A.-R., et al., Maternal Dietary Patterns and Birth Outcomes: A Systematic Review and Meta-Analysis.Advances in Nutrition, 2019. 10(4): p. 685-695.

6.​ Neggers, Y.H., et al., Dietary intake of selected nutrients affects bacterial vaginosis in women. The Journal of nutrition, 2007. 137(9): p. 2128-2133.

7.​ Bradshaw, C.S., et al., High recurrence rates of bacterial vaginosis over the course of 12 months after oral metronidazole therapy and factors associated with recurrence. Journal of Infectious Diseases, 2006. 193(11): p. 1478-1486.

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